In January 2020, the DentaQuest Partnership published an article in Decisions in Dentistry that evaluated Medicaid claims of alternative payment models (APMs) and fee for service (FFS). Key takeaways from the their study demonstrated that:
- In 2016, the Center for Health Care Strategies noted “states may be able to use their purchasing power to encourage better access, quality and accountability in oral health care for children in Medicaid — particularly through contracting with dental plans.”
- This analysis of a national sample of Medicaid dental claims found an approximate 6% increase (from 27% to 33%) in dental claims associated with APMs from 2013 to 2017.
- The costs over the lifespan for APMs were lower than traditional FFS models, while utilization was better in the APM plans.
- Dental utilization in this sampling was highest during pediatric care and sharply declines within the 20s, before remaining low for the rest of the lifespan.